Assessment of the patient flow at the infectious diseases institute out-patient clinic, Kampala, Uganda

Abstract

In order to cope with the increasing patient load, a study was performed to identify bottlenecks in patient flow at the Infectious Diseases out-patient clinic in Kampala, Uganda on 10 January 2005. On a standardised questionnaire we recorded for all patients: the time they presented at reception, waiting times for different services and in- and out times for nursing, counselling and doctor visits. 250 patients visited the clinic the study day: 36 (20 per cent) were asymptomatic; 133 (75 per cent) symptomatic but not critically ill and 8 (4.5 per cent) severely ill; 63 (37.5 per cent) were on antiretroviral treatment. The median time spend at the clinic was 157 minutes (range 22–426). The median time from reception to the triage/vital-signs measuring unit was 34 minutes (range 3–92), from triage nurse to doctor 51 minutes (range 1–205), from doctor to pharmacy 24 minutes (range 5–292). The median waiting time at the pharmacy was 30 minutes (range 10–175). Based on these results, organisational changes were proposed. A similar methodology could be used to evaluate and compare health service delivery systems for persons with HIV infection in Africa in order to identify the most efficient models of care.